Beginning about half way through this Meet the Press clip, WaPo columnist E. J. Dionne chews Senator Orrin Hatch (R-UT) a brand new one. Dionne underscores several key points about the use of reconciliation exceptionally-well. He points out that Republicans have used it on many occasions for what Hatch calls “sweeping social legislation.” He notes that reconciliation would only be used for a portion of HCR. Then he brings out the point he made in his last column (flagged here by TDS) that it’s wrong to let “a phony argument about process get in the way of health coverage for 30 million Americans.” Dionne’s response provides an excellent debate template for health care reform advocates.

In his OpenLeft post, “Yes, Congressional Progressives won major public option concessions in the health reform bill,” Chris Bowers has a potent antidote for a defeatist meme that has popped up here and there on the progressive blogosphere: that progressive activists got rolled, and consequently, the Democratic HCR package ain’t worth spit. To which Bowers responds:

…That entire line of “argument” is just demonstrably false, and either intellectually dishonest or blinded by egregious cynicism…Here are two huge public option concessions that ended up in the Senate bill as concessions to progressive activists and members of Congress:
1. Four million additional Americans covered by Medicaid
Back in July, the health reform proposal in the House (PDF, p. 17) expanded Medicaid coverage by 11 million compared to current law. In an attempt to win over the 60 House Progressives who demanded a public option tied to Medicare rates, Speaker Pelosi increased the Medicaid coverage in the health reform proposal to 15 million more than current law. This was done entirely as a sweetner to Progressives, most of whom come from districts with a disproportionately large number of constituents who would be eligible for Medicaid expansion. Furthermore, even though it was accomplished through a slightly different policy means, that expansion of Medicaid to 15 million more people than current law remained in the Senate bill (CBO report, PDF, page 20)
The House Progressives who signed the infamous July 31st letter demanding a public option tied to Medicare rates did not just fold and walk away with nothing. They got four million, uninsured, low-income Americans public health insurance. They were additionally given a chance by the leadership to whip the entire House caucus on a Medicare +5% public option in the insurance exchange. They came close, but failed to reach 218. That was also a concession they won from the July letter.
2. Twenty-five million additional Americans provided public health care
On December 16th, Senator Bernie Sanders was still threatening to vote against cloture on the Senate health reform bill. Three days later he was on board, but only after securing public health care (not health insurance, health care) for 25,000,000 million, largely low-income Americans:

To amplify the latter point, Bowers flags the following from Sanders’ website:

WASHINGTON, December 19 – A $10 billion investment in community health centers, expected to go to $14 billion when Congress completes work on health care reform legislation, was included in a final series of changes to the Senate bill unveiled today.
The provision, which would provide primary care for 25 million more Americans, was requested by Sen. Bernie Sanders (I-Vt.).
He said the additional resources will help bring about a revolution in primary health care in America and create new or expanded health centers in an additional 10,000 communities. The provision would also provide loan repayments and scholarships through the National Health Service Corps to create an additional 20,000 primary care doctors, dentists, nurse practitioners, physician assistants and mental health professionals.
Very importantly, Sanders also said the provision would save Medicaid tens of billions of dollars by keeping patients out of emergency rooms and hospitals by providing primary care when then needed it.

Bowers adds that “This was won as a direct concession for Sanders’ vote on cloture,” and

…Given a chance to pass a bill that is the largest expansion of public health insurance and health care in 45 years, and when netroots progressive activism campaigns played vital roles in improving those portions of the bill, you’re damn right I want to it passed.
We were fighting to expand public health insurance. We got public health insurance for 15,000,000, uninsured low-income Americans, and we got public health care for 25,000,000 low-income million Americans. Much of what has won was directly the result of the public option campaign. And yes, we are still fighting for even more, no matter the odds. No matter the outcome of that campaign, however, if the health reform bill passes, then the public option campaign was a success.

Bowers expanded his argument with a 9-point rebuttal in his post yesterday, “The complete list of ways progressives strengthened health reform legislation,” also a tonic for checking cynicism and despair about HCR among progressives.

This item is cross-posted from Progressive Fix.
For all the talk about the Tea Party Movement and its demands that America’s political system be turned upside down, it’s always been a bit hard to get a fix on what, exactly, these conservative activists want Washington to do.
To solve this puzzle, it’s worth taking a look at the Contract From America process — a project of the Tea Party Patriots organization, designed to create a bottoms-up, open-source agenda that activists can embrace when they gather for their next big moment in the national media sun on April 15. The 21-point agenda laid out for Tea Partiers to refine into a 10-point “Contract” is, to put it mildly, a major Blast from the Past, featuring conservative Republican chestnuts dating back decades.
There’s term limits, naturally. There are a couple of “transparency” proposals, such as publication of bill texts well before votes. But more prominent are fiscal “ideas” very long in the tooth. You got a balanced budget constitutional amendment, which ain’t happening and won’t work. You got fair tax/flat tax, the highly regressive concept flogged for many years by a few talk radio wonks, that has never been taken seriously even among congressional Republicans. You’ve got Social Security and Medicare privatization (last tried by George W. Bush in 2005) and education vouchers. You’ve got scrapping all federal regulations, preempting state and local regulations, and maybe abolishing some federal departments (an idea last promoted by congressional Republicans in 1995). You’ve got abolition of the “death tax” (i.e., the tax on very large inheritances). And you’ve got federal spending caps, which won’t actually roll back federal spending because they can’t be applied to entitlements.
My favorite on the list is a proposal that in Congress “each bill…identify the specific provision of the Constitution that gives Congress the power to do what the bill does.” This illustrates the obliviousness or hostility of Tea Partiers to the long string of Supreme Court decisions, dating back to the 1930s, that give Congress broad policymaking powers under the 14th Amendment and the Spending and Commerce Clauses. More broadly, it shows the literalism of Tea Party “original intent” views of the Constitution; if wasn’t spelled out explicitly by the Founders it’s unconstitutional.
We are often told that the Tea Party Movement represents some sort of disenfranchised “radical middle” in America that rejects both major parties’ inability to get together and solve problems. As the “Contract From America” shows, that’s totally wrong. At least when it comes to policy proposals, these folks are the hard-right wing of the Republican Party, upset that Barry Goldwater’s agenda from 1964 has never been implemented.

The big hurdle ahead in enacting health care reform is House approval of the Senate HCR bill, which the Administration hopes to pass by March 18. Says OpenLeft‘s Chris Bowers, who tracks the House and Senate tallies: “The vote count is not a rosy one right now.”
538.com‘s Nate Silver believes that “the Senate should fairly easily have 50 votes for reconciliation” and agrees that the House vote is the more problematic challenge:

The math on holding those 217 House votes was never very easy for Nancy Pelosi and its not clear that it’s gotten any easier. If everyone voted the same way today that they did in November, the bill would pass 217-215. However, two previous yes votes — Bart Stupak and the Republican Anh “Joseph” Cao — are almost certainly to be lost, whereas nobody who voted against the bill before has yet affirmed that they’ll switch to vote for it. That makes the starting point 215-217 against.
…My head says yes — Pelosi will squeak this through — while my gut frankly says no…I’d hesitate to call the bill a favorite to pass.

Bowers has a list of about two dozen House members thought to be possible swing voters, broken down into three categories:

…The 431 current members of the House voted 217-214 in favor of the health reform bill in November. Here are the key switches, and wavering Representatives, so far:
* November “yes” votes presumed to be “no” because of the Stupak bloc (9): Cao (LA-02); Costello (IL-12); Dahlkemper (PA-03); Driehaus (OH-03); Kanjorski (PA-11); Kaptur (OH-09); Murtha (PA-12)[deceased]; Oberstar (MN-08); Ortiz (TX-27); Stupak (MI-01)
* November “no” votes publically wavering now (13): Altmire (PA-04), Baird (WA-03); Boucher (VA-09); Boyd (FL-02); Gordon (TN-06); Kosmas (FL-24); Markey (CO-04); McMahon (NY-13); Minnick (ID-01); S. Murphy (NY-20); Glen Nye (VA-02); Ross (AR-04); Tanner (TN-08)
* November “yes” votes publically wavering now (3): Arcuri (NY-24), Grijalva (AZ-07); Schrader (OR-05)
That’s a pretty tight squeeze. The House leadership will need virtually all of the wavering “no” votes from November listed above to vote yes this time around. And the only way to appeal to that group is through the reconciliation fix bill, since the Senate bill must be passed as is in order for President Obama to sign it into law.

Reasons for the March 18 deadline include the President’s upcoming international trip and the onset of “March Madness,” regarded as a constituent distraction. This will likely be the pivotal vote in enacting a decent health care bill, and we can imagine the lobbying pressure the insurance industry will be putting on these House members in the weeks ahead. Much depends on them hearing from progressive constituents and organizations in impressive numbers.

Read more…

With Republicans beating the drums incessantly for the proposition that “the American people have rejected health care reform,” it’s probably not a bad time to recall the discussion that broke out late last year over evidence that many people saying they oppose specific proposals do so because they want to take reform much farther.
Exhibit A was an Ipsos-McClatchey poll taken in November. Here was Nate Silver’s take on it:

Ipsos/McClatchy put out a health care poll two weeks ago. The topline results were nothing special: 34 percent favored “the health care reform proposals presently being discussed”, versus 46 percent opposed, and 20 percent undecided. The negative-12 net score is roughly in line with the average of other polls, although the Ipsos poll shows a higher number of undecideds than most others.
Ipsos, however, did something that no other pollster has done. They asked the people who opposed the bill why they opposed it: because they are opposed to health care reform and thought the bill went too far? Or because they support health care reform but thought the bill didn’t go far enough?
It turns out that a significant minority of about 25 percent of the people who opposed the plan — or about 12 of the overall sample — did so from the left; they thought the plan didn’t go far enough.

Well, Ipsos-McClatchey is back with another poll, and it’s shows an even stronger percentage of reform “opponents” thinking current bills don’t go far enough: more than a third of the 47% of respondents opposing “the reforms being discussed” say it’s because “they don’t go far enough.” Added to the 41% of respondents who say they support “the reforms being discussed,” that’s a pretty significant majority favoring strong government action to reform the health care system.
If that’s right, then maybe a majority of Americans technically favor a “no” vote on health care reform. But it’s not at all clear that they’ll be any happier with a perpetuation of the status quo, much less the kind of “reforms” Republicans are talking about. It looks like a significant share of the public wants something with a strong public option, or perhaps a full-blown single-payer system. It’s disengenuous to pretend these are people who have linked arms with Rush Limbaugh and congressional Republican leaders to fight against serious reform.
Bill Galston’s correct: Democrats should do what’s right on health reform regardless of the polls. But if they do, it’s worth noting that they really aren’t necessarily sailing into the wind of public opinion.

This item by TDS Co-Editor William Galston is cross-posted from The New Republic.
“With the passage of time,” former Bush administration official Pete Wehner writes today, “President Bush’s decision to champion a new counterinsurgency strategy, including sending 30,000 additional troops to Iraq when most Americans were bone-weary of the war, will be seen as one of the most impressive and important acts of political courage in our lifetime.” Wehner may turn out to be right. And his argument has broader implications that deserve our attention.
Wehner tacitly defines political courage as the willingness to go against public opinion in pursuit of what a leader believes to be the public interest. Fair enough. And unless one believes—against all evidence—that democracies can do without courage, so defined, it follows that there’s nothing necessarily undemocratic about defying public opinion when the stakes are high. After all, the people will soon have the opportunity to pass judgment on the leader’s decision. And they will be able to judge that decision, not by the claims of its supporters or detractors, but by its results.
Note that to accept this argument, as I do, is to deny that President Obama and the Democrats are acting high-handedly—let alone anti-democratically—in moving forward with comprehensive health insurance reform. They genuinely believe that the public interest demands it­—and that the people themselves will eventually agree. And they know that the people will have the last word.
This approach has the firmest possible roots in our constitutional traditions. The Framers deliberately established a republican form of government that is representative rather than plebiscitary. And Alexander Hamilton explained why in Federalist #71: “[T]he people commonly intend the PUBLIC GOOD. … But their good sense would despise the adulator who should pretend that they always reason right about the means of promoting it.” In a republic, the people are always the ultimate source of legitimacy. They are not always the proximate source of wisdom.
Many conservatives don’t seem to understand this distinction. In response to the health care proposal President Obama released prior to the bipartisan summit, Senate Minority Leader Mitch McConnell said, “It’s disappointing that the Democrats in Washington aren’t listening, or are completely ignoring, what Americans across the country have been saying.” House Minority Leader John Boehner responded in the same vein: “The president has crippled the credibility of this week’s summit by proposing the same massive government takeover of health care based on a partisan bill the American people have already rejected. And today’s lead Wall Street Journal editorial accused the Democrats of scheming to pass health reform “merely because they think it’s good for the rest of us”—as though pursuing the public interest were a suspect motive for legislating.
So today’s conservatives have a choice: They can contest health reform and the rest of the Democratic agenda on its merits, or they can go down the populist road that Sarah Palin and her followers represent. But let’s call that populism by its rightful name—namely, shameless flattery of the people and the manipulation of public fears and prejudices for short-term political advantage. Honorable conservatives such as Wehner know better. We’re about to find out how many of them there are.

This week’s big preoccupation in the chattering classes is about White House chief of staff Rahm Emanuel. Is he in danger of being fired? Should he be? Is he engaged in a death struggle with David Axelrod and Robert Gibbs? Is he leaking his side of the story to the press? And on and on it goes.
Without question, internecine strife in the White House is a perpetual favorite of the beltway media. But the important thing for Democrats is to avoid the mistake of feeding this dangerous beast by making administration personalities proxies in fights over ideology, strategy or tactics, or scapegoats for disappointments and frustrations.
Unfortunately, such proxy wars are in great danger of getting out of control. Some progressives, with honest and sincere objections to various policies and rhetoric of the Obama administration, have seized on Emanuel as a Rasputin figure: he’s the key player in a “centrist” Clintonian clique that’s ruining the promise of Obama’s presidency; he’s an unprincipled tactician who sells out progressive policies; he bears responsibility for recruiting “conservatives” to run for office as Democrats when he chaired the DCCC; his friends are a bunch of corporate whores. Some “centrists” return the favor by creating a distorted caricature of Emanuel as the sole heroic realist in the White House fighting a lonely battle against impractical ideologues who’d prefer Republican victory to any accommodation of public opinion on their pet issues. Republicans themselves, of course, are gleefully piling on, agreeing with every available attack on every figure in the administration, while the political gossip columnists of the media exploit the opportunity to keep the daily debate as lurid and superficial as possible.
Democrats can’t stop the gossip columnists or the Republicans, both of whom have their own distasteful ulterior motives for promoting this divisive narrative, but they can firmly and emphatically refuse to participate in this profoundly destructive game – and they better start doing so right now. Barack Obama is the president, and there’s nothing in his background or present behavior to suggest that he’s the passive tool of his own staff or disengaged from the decisions that bear his name. In this White House as in any other, there is a place for strategists and for tacticians, for visionaries and for pragmatists, for people who are protecting the presidential “brand” and for people who don’t think much beyond this November. This White House, like every other, has made, and will continue to make, mistakes—some big, some little, some whose consequences nobody is in a position to calculate. At this exceptionally complicated moment in political history, there’s rarely any blindingly obvious course of action for the administration that only a fool or a knave would fail to undertake. We all have our opinions about what’s gone right or wrong on issues ranging from the minutiae of health care policy to the broad outlines of the Democratic Party’s message, and second-guessing is inherent to human nature. But converting our necessary disagreements over substantive issues into personality-based political soap opera represents an act of foolish self-indulgence that no successful political enterprise can endure for long.
At some point—at this point—it really is time to stop pointing fingers and focus on the political tasks just ahead. Encouraging “internecine war” narratives in the media is never a good idea, and it’s a particularly bad idea when it tends to make the president look weak and manipulated, and make his advisors look petty and divided. The president is the only one in a position to completely understand how his team functions, and how their strengths and weaknesses can best be managed.
So please, fellow Democrats, let’s not join our opponents in trashing Rahm or Ax or Robert or Valerie or any other satellite in the presidential orbit, and stop projecting our worries and hopes onto people who are invariably more complex than the cartoon caricatures that are imposed on them by observers with personal agendas. The late musician George Harrison once called gossip “the devil’s radio.” Democrats ought to avoid joining in political insider gossip of the type we are hearing right now like it’s the devil himself.

HCR supporters seeking a compelling rebuttal of the Republican meme that the budget reconciliation process is somehow undemocratic need look no farther than E. J. Dionne Jr.’s WaPo op-ed, “The Republicans’ big lie about reconciliation.” Dionne gives President Obama due credit for including some of the Republicans’ favored provisions in the HCR package, and then addresses President Obama’s commitment to pass the legislation in keeping with the democratic process, despite GOP myth-mongering:

…What he’s (rightly) unwilling to do is give the minority veto power over a bill that has deliberately and painfully worked its way through the regular legislative process.
Republicans, however, don’t want to talk much about the substance of health care. They want to discuss process, turn “reconciliation” into a four-letter word and maintain that Democrats are “ramming through” a health bill.
It is all, I am sorry to say, one big lie — or, if you’re sensitive, an astonishing exercise in hypocrisy.

Dionne then addresses Republican Sen. Orrin Hatch’s distortion of the use of the budget reconciliation process to “ram through the Senate a multitrillion-dollar health-care bill.” Dionne points out that reconciliation would be used only for some amendments to the legislation. He then nails Hatch for saying that Democratic senators Robert Byrd and Kent Conrad oppose using reconciliation for health care reform:

What he didn’t say is that Byrd’s comment from a year ago was about passing the entire bill under reconciliation, which no one is proposing. As for Conrad, he made clear to The Post’s Ezra Klein this week that it’s perfectly appropriate to use reconciliation “to improve or perfect the package,” which is the only thing that Democrats have proposed doing through reconciliation.

Hatch, like many other Republicans strains to characterize the use of reconciliation as illegitimate in passing health reform measures. But Dionne isn’t having any of this particular brand of GOP hypocrisy:

Hatch said that reconciliation should not be used for “substantive legislation” unless the legislation has “significant bipartisan support.” But surely the 2001 and 2003 Bush tax cuts, which were passed under reconciliation and increased the deficit by $1.7 trillion during his presidency, were “substantive legislation.” The 2003 dividends tax cut could muster only 50 votes. Vice President Dick Cheney had to break the tie. Talk about “ramming through.”
The underlying “principle” here seems to be that it’s fine to pass tax cuts for the wealthy on narrow votes but an outrage to use reconciliation to help middle-income and poor people get health insurance.

And then Dionne rolls out the moral imperative: “…It’s not just legitimate to use reconciliation to complete the work on health reform. It would be immoral to do otherwise and thereby let a phony argument about process get in the way of health coverage for 30 million Americans.”
And that’s really the heart of the issue.

Now that President Obama has defined the legislative path forward for HCR (text of his remarks here), and Dems are lining up in support of the consensus, the glaring weakness of the Republicans’ strategy is coming into focus. With benefit of hindsight, it now seems terribly obvious that Republicans hurt their cause with their “throw it out and start over” message.
First, few Americans want to ditch all the work that’s been done and go through the whole yammering process all over again. People are simply growing tired of the health reform debate and it’s hard for a sane person not to agree with President Obama’s point that everything has been said and everyone has had their chance to say it. Clearly, they overestimated the public’s tolerance for never-ending debate.
Second, “let’s start over” is such a transparently partisan notion. ‘Let’s just trash all the Democrats’ efforts, and start over again so we Republicans, who just got one new, pivotal Senate vote, can dominate the deliberations.” No one with a triple-digit I.Q. could possibly believe that idea comes from a genuine bipartisan spirit.
You have to wonder what deluded world the authors of that strategy inhabit. Did they really think the Democrats would roll and say, “OK, you guys are right. let’s start all over again.” No. But it’s equally-dumb to believe that voters would think, “Gee, those reasonable, bipartisan Republicans have a point, we really should start over.”
Instead of “start over,” Republicans might have gotten more support by fighting hard for a few key measures, even if they lost. Then, at least, they would not look quite so obstructionist and negative. Their portfolio of ideas was admittedly limited, but they had a couple of measures they could have been positive about. Instead they went whole hog negative and amped up ‘the party of no’ meme.
Consider an alternate reality. What would be happening now if a few Republicans negotiated in good faith and could credibly claim they had a significant impact on the reforms? The Republican Party could then share some of the credit. Now President Obama and the Dems will get bipartisan cred for including a few Republican ideas of their choosing, while Mitch McConnell and his chorus of whining parrots will be reduced to dissing both majority rule and the enacted legislation, undoubtedly threatening to repeal it (more negativity) at some future date.
Assuming Dems have the votes to enact the legislation pretty soon, perhaps we have just been provided with an instructive lesson about the limitations of message discipline: When a party’s message is that lame, message discipline is not so great.

The President held a press conference today to announce that yes, indeed, he will press Congress to act on health care reform this month. There’s was nothing immensely new about that development, but it’s interesting that Obama used the occasion to lay out, quite succinctly, the three key points he made in his health care summit with Republicans: why comprehensive reform is essential, why the time for “negotiations” is over, and why there’s nothing that unusual about the use of reconciliation (though he did not use the word, a very unfamiliar term to most people outside Washington) to get the job done. He essentially took another bite at the apple of responding to the most effective Republican lines of attack, and will apparently do so some more in appearances on the road this month.
On the other hand, the presidential press conference may get demoted on the nightly news if a possible scandal involving Rep. Eric Massa (D-NY) continues to develop. Massa, a freshman from a highly marginal district, abruptly let it be known he was retiring. Some sources say he’s suffering from a recurrence of cancer, but Politico is reporting that he was about to come under investigation by the Ethics Committee for allegedly sexually harrassing a male staffer. If the latter story has a basis in reality, it will be big news tonight.